Jemds.com Original Article J. Evolution Med. Dent. Sci./ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 5/ Issue 57/ July 18, 2016 Page 3929 EVALUATION OF SCROTAL LESIONS BY GRAY SCALE ULTRASONOGRAPHY AND COLOUR DOPPLER Punya Pratap Singh 1 , Kavita Gahlot 2 , Vivek Agrawal 3 , Manoj Sharma 4 , Himanshu Sharma 5 1 Assistant Professor, Department of Radiodiagnosis, Bundelkhand Medical College, Sagar. 2 Medical Officer, Department of Emergency Medicine, Bundelkhand Medical College, Sagar. 3 Senior Consultant & Intervention Radiologist, Max Super Speciality Hospital, Saket, Delhi. 4 Senior Consultant, Max Super Speciality Hospital, Saket, Delhi. 5 Assistant Professor, Department of Pharmacology, Bundelkhand Medical College, Sagar. ABSTRACT BACKGROUND Until the mid 1970’s, scrotal examination was limited to palpation and transillumination. Miskin and Bain (1974) first reported the use of Ultrasonography to examine testes and scrotum. With advancement like colour Doppler, ability to assess testicular vascularity increased. Although other radiological investigations have roles in specific situations, present study was undertaken to evaluate the usefulness and accuracy of sonography and colour Doppler in scrotal abnormalities. METHODS The study was conducted in the Department of Radiodiagnosis, Max Super Speciality Hospital, Saket, New Delhi, between May 2012 and May 2013. Prospective study carried out in 100 patients after proper informed and written consent with inclusion criteria of ‘All age patients with clinical suspicion of scrotal pathology’ and exclusion criteria of ‘History of operative or therapeutic procedures on the scrotum with exception of vasectomy. ’ These patients’ scrotums were scanned in various plan on “Voluson 730 PRO” (GE Healthcare) system and LOGIC E-9 (GE Healthcare) using linear probe (As applicable) with comparison from asymptomatic side. Relevant other radiological and pathological investigations were done wherever indicated. RESULTS Majority of patients were between 21-40 years of age (62%) with commonest presenting complaint was scrotal swelling in 73%. Fluid collections were the commonest abnormality detected on sonography. Hydrocele was the most frequent fluid collection seen in 38 cases (26.3%). In acute inflammation, hypoechogenicity of the testes was most common sonographic feature. In our study, ultrasound showed 99% accuracy to distinguish between Intratesticular and Extratesticular pathology. CONCLUSIONS High-resolution USG with colour Doppler can reliably define the morphological features and vascularity of scrotal lesions. USG is highly accurate in evaluating the consistency of scrotal mass and in localizing scrotal abnormality. Ultrasound evaluation of the scrotum must include colour Doppler imaging of testis and epididymis with comparison from the asymptomatic side. KEYWORDS High resolution ultrasonography, Colour Doppler, Hydrocele, Varicocele, Scrotal Wall Oedema. HOW TO CITE THIS ARTICLE: Singh PP, Gahlot K, Agrawal V, et al. Evaluation of scrotal lesions by gray scale ultrasonography and colour Doppler. J. Evolution Med. Dent. Sci. 2016;5(57):3929-3940, DOI: 10.14260/jemds/2016/899 INTRODUCTION Until 1970’s examination of the scrotal contents was limited to palpation and transillumination. Miskin and Bain. [1] first reported the use of B (Brightness)-mode Ultrasonography (USG) to examine testes and scrotum. USG have following advantages-High frequency transducers, haemodynamic information, low cost and rapidity in examination and freedom from radiation hazards. AIMS AND OBJECTIVES 1. To evaluate spectrum of ultrasonographic findings in various scrotal pathologies. Financial or Other, Competing Interest: None. Submission 26-01-2016, Peer Review 02-03-2016, Acceptance 07-03-2016, Published 16-07-2016. Corresponding Author: Dr. Punya Pratap Singh, Flat -9, Type–IV Quarters, Block–B, 2 nd Floor, B.M.C. Campus, Sagar-470002, Madhya Pradesh. E-mail: drpunya@gmail.com DOI: 10.14260/jemds/2016/899 2. To evaluate value of colour Doppler in distinguishing and characterizing the blood flow patterns in scrotal pathologies. 3. To assess the role of high frequency real time ultrasonography to accurately distinguish between Testicular and Extratesticular scrotal masses. METHODS The study will be conducted in a tertiary referral teaching hospital; 100 patients were enrolled in the study after proper informed and written consent during the period of study with the following inclusion and exclusion criteria. Inclusion Criteria  Patients with all age groups.  Patients with strong clinical suspicion of scrotal pathology referred for scrotal duplex sonography. Exclusion Criteria  Patients with previous history of operative or therapeutic procedures on the scrotum with exception of vasectomy.